The Oregon Department of Human Services is urging public and private entities charged with preventing and treating addictions and mental illness to help clients quit tobacco.

In a letter to 180 treatment providers, county administrators, prevention specialists, health plans and mental health organizations, Bob Nikkel, DHS assistant director for addictions and mental health, said tobacco cessation has not been a high enough priority.

“In many cases tobacco has been used as a positive reinforcement…,” Nikkel wrote. “Some facilities reward good patient behavior by allowing them to use tobacco.”

Nikkel said people with addictions or mental illness are two to three times more likely to smoke than the general population, and that a Journal of the American Medical Association article reported in 2000 that in the U.S. 44 percent of cigarettes are smoked by this population. “As the nation’s leading preventable cause of disease, disability and death, tobacco is an even more harmful for this population,” he said.

He urged providers to help clients quit tobacco by encouraging them to use the free tobacco “quit line” (1-800-QUIT-NOW) that successfully counsels tobacco users, working with local tobacco coalitions and helping clients engage Oregon Health Plan-financed tobacco-cessation services.

“We want to ensure not only that people are given the resources to quit but also that we do nothing that encourages tobacco use,” he said. “Staff members who use tobacco and work with people who are addicted or mentally ill also should consider the example they are setting.”

Nikkel said state administrative rules prohibit smoking on alcohol and drug treatment providers’ premises, and that a similar rule could be adopted for mental health facilities. Oregon State Hospital was designated a smoke-free hospital in November 1999.

Nikkel said his staff will assist local providers in meeting the state’s request, and that a next step will be to review a Washington state curriculum that shows addictions counselors how to incorporate tobacco cessation into clients’ treatment programs. He said the DHS Public Health Division’s Tobacco Prevention and Education Program also would be involved.

Getting adults in treatment to quit tobacco also would result in setting a good example for their children and in reducing secondhand smoke at home, he said.